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As specialists in musculoskeletal medicine, physical medicine and rehabilitation (PM&R) physicians treat many people looking for relief from their back pain.  These people choose PM&R physicians for their expertise in back pain, but equally important to some is that fact that PM&R is a non-surgical specialty.

As David Bagnall, MD, explains, "We look for non-operative solutions for our patients. As a result, PM&R physicians have taken the lead in performing many of the more advanced, non-surgical procedures to relieve pain." 

An example of these non-surgical treatments is the use of steroid injections to treat back pain. Keeping up with latest technology, PM&R physicians can now offer patients an improved method—fluoroscopically guided steroid injections. This procedure can be used to relieve pain caused by a number of conditions—one of the most common being herniated discs. 

Dr. Bagnall, a PM&R physician with RehabNY in Buffalo, New York, reports that it is rare that a patient needs to undergo surgery to treat a herniated disk. In many cases, the application of steroids can ease the pain. Why steroids? Because PM&R physicians have found that in most cases, it is not the disc itself hurting their patients. The pain often comes when a nerve rubs over that herniated disc. The nerve becomes inflamed and swollen. "It's like when you have a ring on your finger that is too tight and it hurts to put it on and take it off," explains Dr. Bagnall. "My goal is to decrease the pain. I want to break that cycle of inflammation. Your body is constantly trying to heal itself. So when we put the corticosteroid where the nerve is inflamed, it makes the swelling go down and the nerve can again move freely over the disc.

But these injections aren't just Band-Aids for the pain—they help to speed the healing." Dr. Bagnall describes the advantages to the latest advancement— fluroscopically guided inections. "Using X-ray technology, we can see bones and apply the steroid shot directly where it is needed to numb the pain." Previously, patients received a series of three steroid injections. But with the improved accuracy of fluoroscopically guided injections, sometimes only one injection is all that is needed. For more information about the non-surgical treatment offered by PM&R physicians, or to get a list of PM&R physicians in your area, visit

© 2014 American Academy of Physical Medicine and Rehabilitation